When is grounded theory used

To see her other translations, click her blog. Charmaz, Kathy. SAGE Publications. See all library locations. University Libraries. Search this Guide Search. Qualitative Research: Grounded Theory A guide to qualitative research methods.

What is it? How is it done? Covers quantitative, qualitative and mixed methods and includes the entire "Little Green Book" and "Little Blue Book" series. Barney Glaser and Classic Grounded Theory. Grounded Theory Online "Offer online tailored support to research students; support to PhD supervisors and research committees; and consultancy to industry, post doc and professional researchers".

According to Charmaz : " Grounded theory refers to a set of systematic inductive methods for conducting qualitative research aimed toward theory development. In GT, coding can be categorised into iterative phases. Traditional, evolved and constructivist GT genres use different terminology to explain each coding phase Table 1.

Comparison of coding terminology in traditional, evolved and constructivist grounded theory. Adapted from Birks and Mills. Coding terminology in evolved GT refers to open a procedure for developing categories of information , axial an advanced procedure for interconnecting the categories and selective coding procedure for building a storyline from core codes that connects the categories , producing a discursive set of theoretical propositions. The coding terms devised by Birks and Mills 6 were used for Figure 1 ; however, these can be altered to reflect the coding terminology used in the respective GT genres selected by the researcher.

Initial coding of data is the preliminary step in GT data analysis. In initial coding, the researcher inductively generates as many codes as possible from early data. In GT, codes identify social and psychological processes and actions as opposed to themes. Charmaz 16 emphasises keeping codes as similar to the data as possible and advocates embedding actions in the codes in an iterative coding process. Initial coding categorises and assigns meaning to the data, comparing incident-to-incident, labelling beginning patterns and beginning to look for comparisons between the codes.

The process of documenting reactions, emotions and related actions enables researchers to explore, challenge and intensify their sensitivity to the data. The purpose of theoretical sampling is to allow the researcher to follow leads in the data by sampling new participants or material that provides relevant information. As depicted in Figure 1 , theoretical sampling is central to GT design, aids the evolving theory 5 , 7 , 16 and ensures the final developed theory is grounded in the data.

During this process, additional information is sought to saturate categories under development. The analysis identifies relationships, highlights gaps in the existing data set and may reveal insight into what is not yet known. The exemplars in Box 1 highlight how theoretical sampling led to the inclusion of further data.

Thus, theoretical sampling is used to focus and generate data to feed the iterative process of continual comparative analysis of the data. Intermediate coding, identifying a core category, theoretical data saturation, constant comparative analysis, theoretical sensitivity and memoing occur in the next phase of the GT process. Where initial coding fractures the data, intermediate coding begins to transform basic data into more abstract concepts allowing the theory to emerge from the data.

During this analytic stage, a process of reviewing categories and identifying which ones, if any, can be subsumed beneath other categories occurs and the properties or dimension of the developed categories are refined. Properties refer to the characteristics that are common to all the concepts in the category and dimensions are the variations of a property.

At this stage, a core category starts to become evident as developed categories form around a core concept; relationships are identified between categories and the analysis is refined. Birks and Mills 6 affirm that diagramming can aid analysis in the intermediate coding phase. These authors promote storyline technique described in the following section and theoretical coding as strategies for advancing analysis and theoretical integration.

Advanced coding is essential to produce a theory that is grounded in the data and has explanatory power. The findings are presented as a set of interrelated concepts as opposed to presenting themes.

Storyline is a tool that can be used for theoretical integration. Storyline technique is first proposed with limited attention in Basics of Qualitative Research by Strauss and Corbin 12 and further developed by Birks et al. The storyline is the conceptualisation of the core category.

Birks et al. Theoretical coding occurs as the final culminating stage towards achieving a GT. As presented in Figure 1 , theoretical sensitivity encompasses the entire research process. Glaser and Strauss 5 initially described the term theoretical sensitivity in The Discovery of Grounded Theory. Theoretical sensitivity is the ability to know when you identify a data segment that is important to your theory. Developing sensitivity as a grounded theorist and the application of theoretical sensitivity throughout the research process allows the analytical focus to be directed towards theory development and ultimately result in an integrated and abstract GT.

The meticulous application of essential GT methods refines the analysis resulting in the generation of an integrated, comprehensive GT that explains a process relating to a particular phenomenon. Procedural precision requires careful attention to maintaining a detailed audit trail, data management strategies and demonstrable procedural logic recorded using memos. An audit trail of decision-making, changes in the direction of the research and the rationale for decisions made are essential to ensure rigour in the final grounded theory.

This article offers a framework to assist novice researchers visualise the iterative processes that underpin a GT study. The fundamental process and methods used to generate an integrated grounded theory have been described.

Novice researchers can adapt the framework presented to inform and guide the design of a GT study. This framework provides a useful guide to visualise the interplay between the methods and processes inherent in conducting GT. Research conducted ethically and with meticulous attention to process will ensure quality research outcomes that have relevance at the practice level.

National Center for Biotechnology Information , U. Published online Jan 2. Author information Article notes Copyright and License information Disclaimer. Email: ua. Received Jul 30; Accepted Dec This article has been cited by other articles in PMC. Abstract Background: Grounded theory is a well-known methodology employed in many research studies. Objective: The aim of this article is to provide a contemporary research framework suitable to inform a grounded theory study.

Result: This article provides an overview of grounded theory illustrated through a graphic representation of the processes and methods employed in conducting research using this methodology. Discussion: As grounded theory is not a linear process, the framework illustrates the interplay between the essential grounded theory methods and iterative and comparative actions involved.

Conclusion: Rather than an engagement in philosophical discussion or a debate of the different genres that can be used in grounded theory, this article illustrates how a framework for a research study design can be used to guide and inform the novice nurse researcher undertaking a study using grounded theory. Keywords: Framework, grounded theory, grounded theory methods, novice researcher, study design.

Background History Glaser and Strauss are recognised as the founders of grounded theory. Genres: traditional, evolved and constructivist grounded theory Grounded theory has several distinct methodological genres: traditional GT associated with Glaser; evolved GT associated with Strauss, Corbin and Clarke; and constructivist GT associated with Charmaz. Research process Before commencing any research study, the researcher must have a solid understanding of the research process.

Results The following section provides insight into the process of undertaking a GT research study. Open in a separate window. Figure 1. Constant comparative analysis Constant comparative analysis is an analytical process used in GT for coding and category development. Coding Coding is an analytical process used to identify concepts, similarities and conceptual reoccurrences in data. Charmaz 10 posits, codes rely on interaction between researchers and their data. Table 1. Initial coding Initial coding of data is the preliminary step in GT data analysis.

Theoretical sampling The purpose of theoretical sampling is to allow the researcher to follow leads in the data by sampling new participants or material that provides relevant information. Box 1. Examples of theoretical sampling. In Edwards 36 grounded theory study, theoretical sampling led to the inclusion of the partners of women who had presented to the emergency department.

This statement led me to ask other women during their interviews if they had similar experiences, and ultimately to interview the partners to gain their perspectives.

Intermediate coding Intermediate coding, identifying a core category, theoretical data saturation, constant comparative analysis, theoretical sensitivity and memoing occur in the next phase of the GT process. Box 2. Writing the storyline. To address the gaps the researcher iteratively returned to the data and to the field and refine the storyline.

Theoretical sensitivity As presented in Figure 1 , theoretical sensitivity encompasses the entire research process. Box 3. Theoretical sensitivity. Hoare et al. The grounded theory The meticulous application of essential GT methods refines the analysis resulting in the generation of an integrated, comprehensive GT that explains a process relating to a particular phenomenon.

Conclusion This article offers a framework to assist novice researchers visualise the iterative processes that underpin a GT study. Many authors label their work 'grounded theory' but do not follow the basics of the methodology [ 10 , 11 ]. This may be in part because there are few practical examples of grounded theory in use in the literature.

To address this problem, we will provide a brief outline of the history and diversity of grounded theory methodology, and a worked example of the methodology in practice. Founded on the seminal book 'The Discovery of Grounded Theory' [ 12 ], the grounded theory tradition is now diverse and somewhat fractured, existing in four main types, with a fifth emerging.

The fifth, emerging variant is 'Dimensional Analysis' [ 17 ] which is being developed from the work of Leonard Schaztman, who was a colleague of Strauss and Glaser in the s and s.

There has been some discussion in the literature about what characteristics a grounded theory study must have to be legitimately referred to as 'grounded theory' [ 18 ]. The fundamental components of a grounded theory study are set out in Table 1.

These components may appear in different combinations in other qualitative studies; a grounded theory study should have all of these. As noted, there are few examples of 'how to do' grounded theory in the literature [ 18 , 19 ]. Those that do exist have focused on Strauss and Corbin's methods [ 20 — 25 ]. An exception is Charmaz's own description of her study of chronic illness [ 26 ]; we applied this same variant in our study. In the remainder of this paper, we will show how each of the characteristics of grounded theory methodology worked in our study of dental practices.

We know that preventive techniques can arrest early tooth decay and thus reduce the need for fillings [ 28 — 32 ]. Unfortunately, most dentists worldwide who encounter early tooth decay continue to drill it out and fill the tooth [ 33 — 37 ].

The MPP tested whether dentists could increase their use of preventive techniques. In the intervention arm, dentists were provided with a set of evidence-based preventive protocols to apply [ 38 ]; control practices provided usual care. The MPP protocols used in the RCT guided dentists to systematically apply preventive techniques to prevent new tooth decay and to arrest early stages of tooth decay in their patients, therefore reducing the need for drilling and filling.

The protocols focused on 1 primary prevention of new tooth decay tooth brushing with high concentration fluoride toothpaste and dietary advice and 2 intensive secondary prevention through professional treatment to arrest tooth decay progress application of fluoride varnish, supervised monitoring of dental plaque control and clinical outcomes [ 38 ].

As the RCT unfolded, it was discovered that practices in the intervention arm were not implementing the preventive protocols uniformly. Why had the outcomes of these systematically implemented protocols been so different? This question was the starting point for our grounded theory study. We aimed to understand how the protocols had been implemented, including the conditions and consequences of variation in the process.

We hoped that such understanding would help us to see how the norms of Australian private dental practice as regards to tooth decay could be moved away from drilling and filling and towards evidence-based preventive care. Figure 1 illustrates the steps taken during the project that will be described below from points A to F. Grounded theory studies are generally focused on social processes or actions: they ask about what happens and how people interact. This shows the influence of symbolic interactionism, a social psychological approach focused on the meaning of human actions [ 39 ].

Grounded theory studies begin with open questions, and researchers presume that they may know little about the meanings that drive the actions of their participants. Accordingly, we sought to learn from participants how the MPP process worked and how they made sense of it. We wanted to answer a practical social problem: how do dentists persist in drilling and filling early stages of tooth decay, when they could be applying preventive care?

We asked research questions that were open, and focused on social processes. Our initial research questions were:. What was the process of implementing or not-implementing the protocols from the perspective of dentists, practice staff, and patients?

In our experience, medical researchers are often concerned about the ethics oversight process for such a flexible, unpredictable study design. We managed this process as follows. In our application, we explained grounded theory procedures, in particular the fact that they evolve. In our initial application we provided a long list of possible recruitment strategies and interview questions, as suggested by Charmaz [ 15 ].

We indicated that we would make future applications to modify our protocols. We did this as the study progressed - detailed below. Each time we reminded the committee that our study design was intended to evolve with ongoing modifications. Each modification was approved without difficulty. As in any ethical study, we ensured that participation was voluntary, that participants could withdraw at any time, and that confidentiality was protected.

All responses were anonymised before analysis, and we took particular care not to reveal potentially identifying details of places, practices or clinicians.

Grounded theory studies are characterised by theoretical sampling, but this requires some data to be collected and analysed. Sampling must thus begin purposively, as in any qualitative study. Participants in the previous MPP study provided our population [ 27 ]. With permission of the ethics committee; we sent letters to the participants in the MPP, inviting them to participate in a further qualitative study. From those who agreed, we used the quantitative data from the MPP to select an initial sample.

Then, we selected the practice in which the most dramatic results had been achieved in the MPP study Dental Practice 1. This was a purposive sampling strategy, to give us the best possible access to the process of successfully implementing the protocols.

We interviewed all consenting staff who had been involved in the MPP one dentist, five dental assistants. We then recruited 12 patients who had been enrolled in the MPP, based on their clinically measured risk of developing tooth decay: we selected some patients whose risk status had gotten better, some whose risk had worsened and some whose risk had stayed the same. This purposive sample was designed to provide maximum variation in patients' adoption of preventive dental care.

One hour in-depth interviews were conducted. The initial 18 participants one dentist, five dental assistants and 12 patients from Dental Practice 1 were interviewed in places convenient to them such as the dental practice, community centres or the participant's home. Two initial interview schedules were designed for each group of participants: 1 dentists and dental practice staff and 2 dental patients.

Interviews were semi-structured and based loosely on the research questions. The initial questions for dentists and practice staff are in Additional file 1. Interviews were digitally recorded and professionally transcribed. The research location was remote from the researcher's office, thus data collection was divided into two episodes to allow for intermittent data analysis. Dentist and practice staff interviews were done in one week.

The researcher wrote memos throughout this week. The researcher then took a month for data analysis in which coding and memo-writing occurred.

Then during a return visit, patient interviews were completed, again with memo-writing during the data-collection period. Coding is essential to the development of a grounded theory [ 15 ].

According to Charmaz [[ 15 ], p46], 'coding is the pivotal link between collecting data and developing an emergent theory to explain these data. Through coding, you define what is happening in the data and begin to grapple with what it means'. Coding occurs in stages. In initial coding, the researcher generates as many ideas as possible inductively from early data. In focused coding, the researcher pursues a selected set of central codes throughout the entire dataset and the study.

This requires decisions about which initial codes are most prevalent or important, and which contribute most to the analysis. In theoretical coding, the researcher refines the final categories in their theory and relates them to one another. Charmaz's method, like Glaser's method [ 13 ], captures actions or processes by using gerunds as codes verbs ending in 'ing' ; Charmaz also emphasises coding quickly, and keeping the codes as similar to the data as possible. We have provided a worked example of coding in Table 2.

Gerunds emphasise actions and processes. Initial coding identifies many different processes. After the first few interviews, we had a large amount of data and many initial codes. This included a group of codes that captured how dentists sought out evidence when they were exposed to a complex clinical case, a new product or technique. Because this process seemed central to their practice, and because it was talked about often, we decided that seeking out evidence should become a focused code.

By comparing codes against codes and data against data, we distinguished the category of "seeking out evidence" from other focused codes, such as "gathering and comparing peers' evidence to reach a conclusion", and we understood the relationships between them.

Using this constant comparative method see Table 1 , we produced a theoretical code: "making sense of evidence and constructing knowledge". This code captured the social process that dentists went through when faced with new information or a practice challenge. This theoretical code will be the focus of a future paper. Throughout the study, we wrote extensive case-based memos and conceptual memos.

They contained the interviewer's impressions about the participants' experiences, and the interviewer's reactions; they were also used to systematically question some of our pre-existing ideas in relation to what had been said in the interview. Table 3 illustrates one of those memos. We also wrote conceptual memos about the initial codes and focused codes being developed, as described by Charmaz [ 15 ].

We used these memos to record our thinking about the meaning of codes and to record our thinking about how and when processes occurred, how they changed, and what their consequences were. In these memos, we made comparisons between data, cases and codes in order to find similarities and differences, and raised questions to be answered in continuing interviews.

Table 4 illustrates a conceptual memo. At the end of our data collection and analysis from Dental Practice 1, we had developed a tentative model of the process of implementing the protocols, from the perspective of dentists, dental practice staff and patients. This was expressed in both diagrams and memos, was built around a core set of focused codes, and illustrated relationships between them.

We have already described our initial purposive sampling.